Comments for better understanding of the study clinical characteristics and prognostic factors in COVID-19 patients aged ≥80 years.

Dear Editor,

We have read with interest the original article from authors Covino et al. entitled “Clinical characteristics and prognostic factors in COVID‐19 patients aged ≥80 years.” The authors aimed to describe the clinical presentation of patients aged ≥80 years with coronavirus disease 2019 (COVID‐19), and provide insights regarding the prognostic factors and the risk stratification in this population. Consequently, the authors conclude that the risk of death could not be age dependent in patients aged ≥80 years, whereas severe dementia emerged as a relevant risk factor for death in this population. However, we have some comments related to this study.

“Severe Dementia” was not defined in the methodology. The comparison was made between patients with severe dementia where two survived and six died, which was found statistically significant. However, the study found only eight of 69 (11.6%) patients with dementia. Importantly, we should not ignore 17 of 23 (74%) patients who had died because of other comorbidities without dementia.

The study concluded that risk of death could not be age dependent in patients aged ≥80 years. On the contrary, the case fatality rate of COVID‐19 increases with old age. In addition, the presence of comorbidities was found associated with greater disease severity and poor clinical outcomes, hence risk increases with the number of comorbidities a patient has. While comparing comorbidities, the authors found there was no statistically significant difference between patients with COVID‐19 that survived versus those that died. Age along with the number of comorbidities with duration and severity would have played an important role in the primary endpoint of the study, i.e., death.

One statement of confusion was that dementia was an independent risk factor for death in the discussion yet was a relevant risk factor in the conclusion. For an identical age group (≥80 years) using a study with this small sample size, severe dementia probably may not be the independent risk factor for death due to COVID‐19, but definitely it may act as an independent risk factor if a study includes patients from all age groups, controlling for all possible risk factors.

It would have been better if the study could include more descriptive statistics for statistically significant variables found in the patients who died. It might have helped us to understand more about the prognostic factors among elderly patients with COVID‐19.

Disclosure statement

The authors declare no conflict of interest.